Dipartimenti di Prevenzione durante la pandemia tra le criticità strutturali e l’emergenza

I dipartimenti di prevenzione, entità scarsamente integrate finora nelle aziende sanitarie locali di cui fanno parte, sono state coinvolte in prima linea durante le diverse ondate della pandemia. L'obiettivo del contributo è comprendere se e come questa esperienza abbia contribuito a mutare nel breve e nel lungo termine il posizionamento di questi dipartimenti nelle aziende sanitarie lovali

Tinnitus and Neuropsychological Dysfunction in the Elderly: A Systematic Review on Possible Links

Introduction: Tinnitus is a common and disabling symptom often associated with hearing loss. While clinical practice frequently shows that a certain degree of psychological discomfort often characterizes tinnitus suffers, it has been recently suggested in adults as a determining factor for cognitive decline affecting attention and memory domains. The aim of our systematic review was to provide evidence for a link between tinnitus, psychological distress, and cognitive dysfunction in older patients and to focus on putative mechanisms of this relationship. Methods: We performed a systematic review, finally including 192 articles that were screened. This resulted in 12 manuscripts of which the full texts were included in a qualitative analysis. Results: The association between tinnitus and psychological distress, mainly depression, has been demonstrated in older patients, although only few studies addressed the aged population. Limited studies on cognitive dysfunction in aged patients affected by chronic tinnitus are hardly comparable, as they use different methods to validate cognitive impairment. Actual evidence does not allow us with certainty to establish if tinnitus matters as an independent risk factor for cognitive impairment or evolution to dementia. Conclusion: Tinnitus, which is usually associated with age-related hearing loss, might negatively affect emotional wellbeing and cognitive capacities in older people, but further studies are required to improve the evidence

The web of laughter: frontal and limbic projections of the anterior cingulate cortex revealed by cortico-cortical evoked potential from sites eliciting laughter

According to an evolutionist approach, laughter is a multifaceted behaviour affecting social, emotional, motor and speech functions. Albeit previous studies have suggested that high-frequency electrical stimulation (HF-ES) of the pregenual anterior cingulate cortex ( pACC) may induce bursts of laughter—suggesting a crucial contribution of this region to the cortical con- trol of this behaviour—the complex nature of laughter implies that outward connections from the pACC may reach and affect a complex network of fron- tal and limbic regions. Here, we studied the effective connectivity of the pACC by analysing the cortico-cortical evoked potentials elicited by single-pulse electrical stimulation of pACC sites whose HF-ES elicited laugh- ter in 12 patients. Once these regions were identified, we studied their clinical response to HF-ES, to reveal the specific functional target of pACC representation of laughter. Results reveal that the neural representation of laughter in the pACC interacts with several frontal and limbic regions, including cingulate, orbitofrontal, medial prefrontal and anterior insular regions—involved in interoception, emotion, social reward and motor be- haviour. These results offer neuroscientific support to the evolutionist approach to laughter, providing a possible mechanistic explanation of the interplay between this behaviour and emotion regulation, speech production and social interactions. This article is part of the theme issue ‘Cracking the laugh code: laughter through the lens of biology, psychology, and neuroscience’

Diagnosis, Management and Theragnostic Approach of Gastro-Entero-Pancreatic Neuroendocrine Neoplasms

Abstract: Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) constitute an ideal target for radiolabeled somatostatin analogs. The theragnostic approach is able to combine diagnosis and therapy by the identification of a molecular target that can be diagnosed and treated with the same radiolabeled compound. During the last years, advances in functional imaging with the introduction of somatostatin analogs and peptide receptor radionuclide therapy, have improved the diagnosis and treatment of GEP-NENs. Moreover, PET/CT imaging with 18F-FDG represents a complementary tool for prognostic evaluation of patients with GEP-NENs. In the field of personalized medicine, the theragnostic approach has emerged as a promising tool in diagnosis and management of patients with GEP-NENs. The aim of this review is to summarize the current evidence on diagnosis and management of patients with GEP-NENs, focusing on the theragnostic approach

Stigma in the context of schools: analysis of the phenomenon of stigma in a population of university students

Background Students have stereotyped views about people with mental illness. In particular, they believe that these persons are incurable, dangerous, unpredictable and responsible for their condition. This study aims to investigate the levels of public stigma in an Italian university population. Methods The Attribution Questionnaire 27 - Italian Version (AQ-27-I) was administered to a sample of students from the Faculty of Medicine and Surgery of the University of Modena and Reggio Emilia. After examining the psychometric characteristics of the AQ-27-I (Cronbach’s Alpha and Confirmatory Factor Analysis), multiple linear regression analyses were carried out to identify the predictors of stigmatizing attitudes in this population. Results Three hundred and eleven students completed the questionnaire, with a response rate of 32.81 % (out of the 948 contacted by email). The AQ-27-I showed good psychometric properties with an α = .68, and the fit indices of the models that partially supported the factor structure and paths. The two variables identified as possible predictors of stigmatizing attitudes (total score of AQ-27-I) were age and time spent reading newspapers. Conclusions Antistigma campaigns are needed in university contexts, targeted in particular to students in health professions

Comparison of two dedicated 'in beam' PET systems via simultaneous imaging of (12)C-induced beta(+)-activity.

The selective energy deposition of hadrontherapy has led to a growing interest in quality assurance techniques such as 'in-beam' PET. Due to the current lack of commercial solutions, dedicated detectors need to be developed. In this paper, we compare the performances of two different 'in-beam' PET systems which were simultaneously operated during and after low energy carbon ion irradiation of PMMA phantoms at GSI Darmstadt. The results highlight advantages and drawbacks of a novel in-beam PET prototype against a long-term clinically operated tomograph for ion therapy monitoring

Il PNRR e i sistemi sanitari regionali: modelli di governance e processi di change management

Il Capitolo si focalizza sul modo in cui, i diversi sistemi sanitari regionali (SSR), si sono occupati della gestione del PNRR, adottando una duplice prospettiva di indagine: i) da una parte si intende studiare il modello di governance scelto dai diversi SSR; ii) dall’altra è obiettivo del lavoro approfondire se i SSR hanno interpretato la gestione del PNRR esclusivamente come un programma di spesa o anche come un’opportunità per un’azione di change management. In particolare, il Capitolo analizza le attività di programmazione relative alle Case di Comunità (CdC), sia in termini di programmazione della spesa che la ri-progettazione dei modello di assistenza territoriale, attraverso la metodologia dei casi studio che sono i SSR di: Campania, Emilia Romagna, Lazio, Lombardia e Molise. Dalle analisi emerge la necessità di rafforzare i livelli regionali, in termini di numerosità e competenze. Il PNRR, sia nel programma di spesa che nella riforma dei servizi territoriali, comporta un incremento delle responsabilità e delle attività del livello regionale, necessario, da un lato, per programmare e realizzare gli investimenti e, dall’altro, per guidare un processo di trasformazione dei servizi e sviluppo delle competenze. In secondo luogo, il contributo suggerisce l’importanza di curare le interdipendenze fra il programma di spesa e il processo di change management mentre i SSR stanno realizzando i due interventi con gruppi di lavoro e tempistiche differenti. In questo caso sorge il rischio che gli investimenti su una singola CdC vengano programmati prima di averne definito la vocazione strategica e i servizi offerti e, di conseguenza, che tali investimenti risultino disfunzionali. Rischi che potrebbero essere mitigati promuovendo delle forme di coordinamento fra i gruppi di lavoro che stanno guidando i due interventi